CN102961175A - External fixing and locking nail plate system for treating femoral intertrochanteric fracture - Google Patents

Abstract

The invention discloses an external fixation locking nail-plate system for the treatment of femoral intertrochanteric fractures, which comprises a femoral locking plate; the inner surface of the femoral locking plate forms a shape similar to the outer skin of the human hip; Upper main locking hole, lower main locking hole, upper auxiliary locking hole, lower auxiliary locking hole, lower locking hole with internal thread and countersunk head, and upper main locking nail with first threaded part, second threaded part and smooth screw rod , The lower main locking nail, the upper auxiliary locking nail, the lower auxiliary locking nail, and the lower locking nail; the thread of the second thread part of the upper main locking nail, the lower main locking nail, the upper auxiliary locking nail and the lower auxiliary locking nail is a coarse thread , the external fixation locking nail-plate system for the treatment of intertrochanteric fractures of the present invention is placed on the outside of the human skin, the fixation effect is good, it is convenient for the patient to wear trousers after the operation, it is convenient for nursing, the operation trauma is small, the operation cost is small, and the outpatient service after the fracture heals The removal operation can be completed, especially for patients with poor cardiopulmonary function.

Description

A locking nail-plate system for external fixation of femoral intertrochanteric fracture

technical field

The invention relates to an external fixation device for femoral intertrochanteric fractures, in particular to an external fixation locking nail-plate system for the treatment of femoral intertrochanteric fractures for frail and osteoporotic elderly people, and belongs to the technical field of femoral fracture fixation.

Background technique

The upper end of the femur includes the femoral head, the femoral neck, and the size and size of the trochanters. The fracture that occurs from the base of the femoral neck to above the level of the lesser trochanter is called an intertrochanteric fracture. It is more common in the elderly over 60 years old. Due to osteoporosis in the elderly, the lower limbs suddenly twist or sharply when they fall. Fractures can occur due to excessive abduction or adduction, or direct impact of external force on the greater trochanter. The treatment of intertrochanteric fractures is one of the most challenging treatments in the field of trauma orthopedics. About 30% of the elderly have serious medical system diseases. If conservative treatment is adopted, they will stay in bed for a long time, and the nursing work is cumbersome. Functionality is clearly affected. Fractures are difficult to obtain good reduction and maintain reduction for a long time. This causes or aggravates the patient's original underlying disease, which is the main reason for the high mortality rate of conservative treatment of intertrochanteric fractures in the elderly. Therefore, actively creating conditions for surgical treatment of intertrochanteric fractures in the elderly has become a general consensus in trauma orthopedics.

There are many surgical treatment methods for femoral fractures, including: 1. Closed multi-root Steiner pin internal fixation: promptly use 4 pieces of diameter 3.5mm Steiner pins to fix femoral neck fracture with multiple Steiner pins. 2. Pin-plate internal fixation: This method is suitable for various types of fractures in adults. The commonly used internal fixation includes DHS (dynamic hip screw) and Charnley sliding compression nails. 3. Gamma nail fixation: that is, a locking intramedullary needle is inserted obliquely through a thick screw passing through the neck of the femoral head. Because the main nail passes through the medullary cavity, from the analysis of biomechanics, the line of force is close to the center of the femoral head, and the Gamma nail femur The inner side can withstand greater stress, which can achieve the purpose of early landing on the ground. 4. Locking plate fixation: The latest internal fixation plate, the unique technology of the locking plate makes it not only the role of the internal fixation plate, but also the role of the internal fixation bracket. There is a certain distance between the plate and the bone surface, so that the bone The blood circulation is relatively improved, but the existing proximal femoral locking and releasing plate is relatively weak, and the incidence of internal fixation failure caused by interrupting the plate and withdrawing the screw in clinical application is high. 5. PFNA: It belongs to a new type of proximal femoral internal fixation system. It is a newly improved PFN (proximal femoral nail) system. On the one hand, it inherits the advantages of the original PFN and has anti-rotation function. It is used for various types of For intertrochanteric fractures and high subtrochanteric fractures, the tail of PFNA is thick, with a diameter of 14-16mm, which may cause bone loss in the proximal femur during implantation. The above treatment methods all require open surgery, the trauma is large, and the cost of surgery and equipment is expensive. After the fracture heals, it needs to be hospitalized again for surgery to remove it. Old people with cardiovascular and cerebrovascular diseases cannot open surgery, and their families often refuse open surgery. Program, passive choice of conservative treatment. External fixators do not require open surgery, but the existing external fixators are bulky and clumsy, inconvenient for nursing, and the existing devices and methods are not the best choice for intertrochanteric fractures in the elderly. For this reason, it is necessary to design a combination of the advantages of internal and external fixation, firm fixation, no need for open surgery, less trauma to the patient, less pain for the patient, no need for open surgery to remove, can be removed in the outpatient operating room, economical External fixation locking nail-plate system for low-cost intertrochanteric fractures.

Contents of the invention

The purpose of the present invention is to overcome the deficiencies of the prior art and provide a more suitable external fixation locking nail-plate system for the treatment of intertrochanteric fractures of the elderly.

In order to achieve the above object, the technical solution of the present invention is: an external fixation locking nail-plate system for the treatment of intertrochanteric fractures, characterized in that: it includes a femoral locking plate; the upper part of the femoral locking plate is the upper plate, and the femoral locking The lower part of the plate is the lower plate part; the inner surface of the femoral locking plate forms a shape similar to the outer thigh skin of a human body; the middle part of the upper plate part is provided with an upper main locking hole and a lower main locking hole; The main locking hole is located above the lower main locking hole; the upper part of the upper plate is provided with an upper secondary locking hole along the center line, and the lower part of the upper plate is provided with a lower secondary locking hole along the center line; the lower plate A lower locking hole is provided along the center line; the upper main locking hole, the lower main locking hole, the upper auxiliary locking hole, the lower auxiliary locking hole, and the lower locking hole are all countersunk holes, and the countersunk holes of the countersunk holes The positions are all located on the outer surface of the femoral locking plate, and the through holes of the countersunk holes are all provided with internal threads; the upper main locking hole, the lower main locking hole, the upper auxiliary locking hole, the lower auxiliary locking hole, the lower The locking holes are respectively equipped with upper main locking nails, lower main locking nails, upper auxiliary locking nails, lower auxiliary locking nails, and lower locking nails; the upper main locking nails, lower main locking nails, upper auxiliary locking nails, and lower auxiliary locking nails Both the nail and the lower locking nail include a first threaded part that cooperates with the internal thread of the counterbore, a second threaded part that is screwed into the inside of the femoral head, and a threaded part that is screwed into the femoral head between the first threaded part and the second threaded part. The light screw rod of the outer skin and flesh tissue; the threads of the second threaded part of the upper main locking nail and the lower main locking nail are all coarse thread threads.

Preferably, the threads of the second threaded portions of the upper secondary locking nail and the lower secondary locking nail are both coarse threads.

In the external fixation locking nail-plate system for the treatment of intertrochanteric fractures of the present invention, the thickened locking plate is placed outside the skin of the proximal thigh on the affected side, and the screw-nut connection between the locking plates is used to achieve the integration of the nail and plate , to prevent the screws from loosening and falling off, the angle stability is good, the fixation effect is good, the plate and the outside of the hip are well adhered, it does not affect the postoperative patient to wear pants, the dressing is convenient, the surgical trauma is small, and the outpatient operation can be completed after the fracture heals. For elderly patients with serious medical diseases who cannot accept open surgery and who are not suitable for long-term bed rest, using this external fixation locking nail-plate system for the treatment of intertrochanteric fractures is an option. Elderly patients have less activity. After using the external fixation locking nail-plate system to fix intertrochanteric fractures, they can move early, reduce complications, and improve the quality of life.

Description of drawings

The present invention will be further described below in conjunction with accompanying drawing:

Accompanying drawing 1 is the perspective view of the external fixation locking nail-plate system for the treatment of femoral intertrochanteric fracture according to the present invention;

Accompanying drawing 2 is the working schematic diagram of external fixation locking nail-plate system for the treatment of intertrochanteric fracture of the present invention;

Accompanying drawing 3 is the structural representation of upper main locking nail 2a, lower main locking nail 2b, upper auxiliary locking nail 3a, lower auxiliary locking nail 3b and lower locking nail 4 according to the present invention;

Among them: 1a, upper plate part; 1b, lower plate part; 2a, upper main locking nail; 2b, lower main locking nail; 3a, upper auxiliary locking nail; 3b, lower auxiliary locking nail; 4, lower locking nail; 5, Fracture of femur; 6. Skin and flesh tissue; 7. First threaded part; 8. Second threaded part; 9. Light screw.

Detailed ways

As shown in accompanying drawing 1-3, a kind of external fixation locking nail-plate system for the treatment of femoral intertrochanteric fracture according to the present invention includes a femoral locking plate; the femoral locking plate is divided into an upper plate part 1a and a lower plate part 1b The upper plate part 1a is located above the lower plate part 1b; the inner surface of the femoral locking plate forms a shape similar to the outer skin of the femur of a human body; the middle part of the upper plate part 1a is arranged along the center line The upper main locking hole and the lower main locking hole; the upper main locking hole is located above the lower main locking hole; the upper part of the upper plate part 1a is provided with an upper auxiliary locking hole along the center line; the upper part of the upper plate part 1a The lower part is provided with a lower auxiliary locking hole along the center line; the lower plate part 1b is provided with three lower locking holes arranged in sequence from top to bottom along the center line; the upper main locking hole, the lower main locking hole, The upper auxiliary locking hole, the lower auxiliary locking hole, and the lower locking hole are all countersunk holes, and the countersunk parts of the countersunk holes are all located on the outer surface of the femoral locking plate, and the through holes of the countersunk holes are all set There are internal threads; the upper main locking hole, the lower main locking hole, the auxiliary locking hole and the lower locking hole are respectively equipped with upper main locking nail 2a, lower main locking nail 2b, auxiliary locking nail 3 and lower locking nail 4; The upper main locking nail 2a, the lower main locking nail 2b, the auxiliary locking nail 3, and the lower locking nail 4 all include a first threaded part 7 that cooperates with the internal thread of the above-mentioned countersunk hole, and a second threaded part 8 that is screwed into the inside of the femoral head. And the light screw rod 9 screwed into the flesh tissue outside the femur that is arranged between the first threaded part 7 and the second threaded part 8; the upper main locking nail 2a, the lower main locking nail 2b, the upper secondary locking nail 3a and the lower The thread of the second thread portion 8 of the secondary locking nail 3b is a coarse thread.

The upper main locking nail 2a and the lower main locking nail 2b are screwed into the flesh tissue 6 by the countersunk hole of the femoral locking plate, and then screwed into the head and neck of the femur through the femoral fracture 5 and the femoral neck from the bottom of the greater trochanter of the femur The upper auxiliary locking nail 3a is screwed into the flesh tissue 6 by the countersunk hole of the femoral locking plate, and then screwed into the upper part of the greater trochanter of the femur; the lower auxiliary locking nail 3b is screwed in by the countersunk hole of the femoral locking plate The flesh tissue 6 is screwed into the lesser trochanter of the femur; the three lower locking nails 4 are all screwed into the flesh tissue 6 through the countersunk holes of the femoral locking plate, and then screwed into the femoral shaft for fixation; because the upper main locking nails 2a, the lower main locking nail 2b, the upper auxiliary locking nail 3a, the lower auxiliary locking nail 3b and the three lower locking nails 4. The first threaded part 7 is engaged with the internal thread in the counterbore hole of the femoral locking plate, so the screw is in use In the process, it is not easy to fall off; and, the coarse tooth thread adopted by the second threaded part 8 of the upper main locking nail 2a, the lower main locking nail 2b, the upper auxiliary locking nail 3a and the lower auxiliary locking nail 3b can better fix the femoral fracture 5 tension; the femoral locking plate is installed on the outside of the skin tissue 6, so it can reduce the surgical trauma caused by open surgery; because there is no screw thread on the light screw rod 9 screwed into the skin tissue 5 of the femur, the passage of bacteria is reduced Possibility of threads entering the femur.

The external fixation locking nail-plate system for the treatment of femoral intertrochanteric fractures of the present invention is on the outside of the human skin, and has a good fixation effect, the locking nails are not easy to fall off, the plate and the outside of the hip are well attached, and it is convenient for patients to wear trousers after surgery, which is convenient for nursing and surgery. The trauma is small, and the outpatient operation can be completed after the fracture heals, which is very suitable for the elderly population who are osteoporotic, frail and sick and cannot accept major surgery.

The above-mentioned embodiments are only to illustrate the technical conception and characteristics of the present invention. Substantial equivalent changes or modifications shall fall within the protection scope of the present invention.

Claims (2)

1. the outer fixedly locked pegboard systems for the treatment of intertrochanteric fracture of the femur is characterized in that: comprise the femur lockplate; The top of described femur lockplate is upper plate portion (1a), and the bottom of femur lockplate is lower board unit (1b); The inner surface of described femur lockplate forms a shape similar to the large leg outer side skin contours of human body; The middle part of described upper plate portion (1a) is provided with main lock hole and lower main lock hole; Described main lock hole is positioned at the top of lower main lock hole; The top of described upper plate portion (1a) is provided with upper secondary lock hole along centrage, and the bottom of upper plate portion (1a) is provided with lower secondary lock hole along centrage; Described lower board unit (1b) is upper to be provided with lower lock hole along centrage; Described main lock hole, lower main lock hole, upper secondary lock hole, lower secondary lock hole, lower lock hole are counter sink, and the countersunk head position of described counter sink all is positioned on the outer surface of femur lockplate, and the throughhole portions of described counter sink is provided with female thread; Described main lock hole, lower main lock hole, upper secondary lock hole, lower secondary lock hole, lower lock hole respectively correspondence are equipped with main locking nail (2a), lower main locking nail (2b), upper secondary locking nail (3a), lower secondary locking nail (3b), lower locking nail (4); Described main locking nail (2a), lower main locking nail (2b), upper secondary locking nail (3a), lower secondary locking nail (3b), lower locking nail (4) all comprise and first threaded portion (7) of the screw-internal thread fit of described counter sink, be screwed into second threaded portion (8) of femoral head inside and be arranged on the first threaded portion (7) and the second threaded portion (8) between the light screw rod (9) that is screwed into the outer skin and flesh tissue (5) of femur; The screw thread of second threaded portion (8) of described main locking nail (2a), lower main locking nail (2b) is coarse thread.

2. the outer fixedly locked pegboard systems for the treatment of intertrochanteric fracture of the femur according to claim 1, it is characterized in that: the screw thread of second threaded portion (8) of described secondary locking nail (3a) and lower secondary locking nail (3b) is coarse thread.

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